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Pregnancy Hyperglycaemia and Risk of Prenatal and Postpartum Depressive Symptoms
Author(s) -
Huang Tianyi,
RifasShiman Sheryl L.,
Ertel Karen A.,
RichEdwards Janet,
Kleinman Ken,
Gillman Matthew W.,
Oken Emily,
JamesTodd Tamarra
Publication year - 2015
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12199
Subject(s) - medicine , odds ratio , pregnancy , gestational diabetes , obstetrics , edinburgh postnatal depression scale , confidence interval , impaired glucose tolerance , diabetes mellitus , anthropometry , depression (economics) , gestation , depressive symptoms , endocrinology , type 2 diabetes , genetics , biology , macroeconomics , economics
Background Glucose dysregulation in pregnancy may affect maternal depressive symptoms during the prenatal and postpartum periods via both physiologic and psychological pathways. Methods During mid‐pregnancy, a combination of 50‐g 1‐h non‐fasting glucose challenge test ( GCT ) and 100‐g 3‐h fasting oral glucose tolerance test was used to determine pregnancy glycaemic status among women participating in P roject V iva: normal glucose tolerance ( NGT ), isolated hyperglycaemia ( IHG ), impaired glucose tolerance ( IGT ) and gestational diabetes mellitus ( GDM ). Using the Edinburgh Postnatal Depression Scale ( EPDS ), we assessed depressive symptoms at mid‐pregnancy and again at 6 months postpartum. We used logistic regression, adjusted for sociodemographic, anthropometric and lifestyle factors, to estimate the odds of elevated prenatal and postpartum depressive symptoms ( EPDS ≥ 13 on 0–30 scale) in relation to GCT glucose levels and GDM status in separate models. Results A total of 9.6% of women showed prenatal and 8.4% postpartum depressive symptoms. Women with higher GCT glucose levels were at greater odds of elevated prenatal depressive symptoms [multivariable‐adjusted odds ratio ( OR ) per standard deviation ( SD ) increase in glucose levels (27 mg/dL): 1.25; 95%: 1.07, 1.48]. Compared with NGT women, the association appeared stronger among women with IHG [ OR : 1.80; 95% confidence interval ( CI ): 1.08, 3.00] than among those with GDM ( OR : 1.45; 95% CI : 0.72, 2.91) or IGT ( OR : 1.43; 95% CI : 0.59, 3.46). Neither glucose levels assessed from the GCT nor pregnancy glycaemic status were significantly associated with elevated postpartum depressive symptoms. Conclusion Pregnancy hyperglycaemia was cross‐sectionally associated with higher risk of prenatal depressive symptoms, but not with postpartum depressive symptoms.